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Street Address (Work)
*

AWID mails out an introductory and welcome membership package to all new members. For this purpose, please ensure that your postal mailing address is complete and correct.

City (Work)
*

Postal Code (Work)
*

Country (Work)
*

State (Work)

Phone-Phone (Work)
*

Website

I would like to receive other updates and information from AWID.
*

YesNo

AWID regularly keeps you updated with the latest news, information, and events — including newsletters, fundraisers, programs, workshops, forums and more. Confirm if you will like to receive those updates.

I agree with the AWID Values
*

YesNo

AWID reserves the right to cancel the membership of any organization not aligned with our values

How did you hear about AWID memberships?
*

Reference organization 1
*

Reference organization 1 email contact
*

Reference organisation 2
*

Please submit the name of an organization/institution which could provide a reference for you.

Reference organization 2 email contact
*

Please enter a contact e-mail address from the organization/institution you indicated above.

Payment Options

Payment Method

Credit CardI will send payment by cheque.

Credit Card Information

Card Type

Card Number*

Security Code*

Expiration Date*

My billing address is the same as above

Billing Name and Address

Billing First Name*

Billing Middle Name

Billing Last Name*

Street Address*

City*

Country*

State/Province*

Postal Code*

Length

1 Year2 Years3 Years

Choose the length of membership

Income

Income less than US$50,000 per yearIncome between US$50,000 - $100,000 per yearIncome more than US$100,000 per year